How can a pen kill pain? And will this impetigo ever go?

Too good to be true

Q. I have received literature about the Pain Gone Pen, which is supposed to be amazingly effective in treating everything from travel sickness to shingles to sciatica. Does it work?

A. The Pain Gone Pen is a small device, about the size of a chunky ballpoint pen. It contains piezoelectric crystals that generate a charge when the button on top of the pen is pressed. The manufacturers claim that when the pen is used on a painful area, the electric charge stimulates a nerve pathway, which sends a "call to help" message to the brain. The brain and spinal cord respond by sending natural painkillers – endorphins – to kill the pain. Does it work? I have no experience of using it and am reluctant to trust the claims of manufacturers, as they may be biased. Stimulating nerves may have some physiological effect, but without reliable evidence, I remain sceptical. And the retail price of £59.95 seems pretty steep.

Recurring problem

Q. When there was an outbreak of impetigo at their school two months ago, both of our children, aged seven and nine, got it. The younger girl was treated with antibiotic cream and got better quickly. The older boy had a worse attack, with spots on hands and face, and had to take antibiotics for a week. Since then, he has had two further attacks on his face, which have both cleared up with cream. Will he continue to get impetigo?

A. Impetigo is a skin infection caused by the bacteria Staphylococcus aureus. It used to be rampant in schools and other institutions, because it spreads easily from person to person, but in recent times it has become less of a problem. The "staph" bacteria infects the skin and causes a crusty rash sometimes described as "golden". If not treated, the rash can spread extensively and even cause scarring. It is easily treated with antibiotics, but is usually resistant to penicillin and amoxicillin. The best antibiotic is flucloxacillin (or erythromycin if allergic to penicillin). If the infection is small and localised, it can usually be eradicated with an antibiotic cream such as fusidic acid. Some people find it hard to get rid of the staph bacteria, and can be symptomless carriers. The bacteria sometimes takes hold in the nose, where it doesn't cause any problems until it breaks out again as a skin infection. If your son continues to have recurrent impetigo, he should have a nasal swab taken to see if he is carrying the staph bacteria inside his nose. If he is, there are nasal antiseptic creams that can be used to eradicate it.

Please send your questions and suggestions to A Question of Health, The Independent, Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182; e-mail health@ Dr Kavalier regrets that he is unable to respond personally to questions

Readers write

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